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Celiac Sprue - 🧠 ANSWER ✔✔otherwise known as celiac diseae. Look for
history of nonbloody diarrhea with weight loss and a vesicular rash
(dermatitis herpetiform). Serum ttransfluatminase is highly sensitivie. Small
bowel biopsy wold show villous atrophy.
Absolutely contraindications to ECT - 🧠 ANSWER ✔✔there are none. ECt
can be used safely in those with cardiac pacemakers and defibirilators and
the very elderly It may also be used in preganncy.
,Diffiuclt to control HTN - 🧠 ANSWER ✔✔noadheerence, use hof alcohol,
NSAIDs, certain antidepressants, or sympathomimetics. Or secondary HTN
Secondary HTN - 🧠 ANSWER ✔✔caused by CKD, obstructve sleep apnea,
or primary hyperaldoseteronism. The omost common is primary
hyperaldosteronism (20%) and is common in women and otherwise
asympatomatic. They may be hypokalemic as a clue since aldosterone
does this. Screen with a morning plasma aldosterone/renin ratio- if ratio is
> 20 and aldosteorne is >15, primary hyperaldosteronism is leading ddx.
CAP in a 15 month old - 🧠 ANSWER ✔✔when there is a focal sound in teh
lung fields- not diffuese wehezing could be a bacterrial infeciton with strept
pneumo. Amoxicllin high dose with close outpatinet follow up would b
eapprorpiate if the child does not appear toxic, hypoxemic, with signs of
respiratory distress, or dehydration.
Introduction of solid food - 🧠 ANSWER ✔✔at 6 months of age.
Midshaft posteromedial tibial stress fracture in a runner - 🧠 ANSWER ✔✔tx:
relative rest from running and avoid activities with pain. Once pain
subsides, start agian slowly. A pneumatic stirrup air leg brace /Aircast. can
be helpful in treatment.
,Late-onset (60) male hypogonadism - 🧠 ANSWER ✔✔screen with a serum
total testosterone level. Get free tesotterone only if total is borderline
because more expswensive. LH and FSH can help distinguish primary from
secondary hypogonadism.
Plantar Fascitis - 🧠 ANSWER ✔✔common cause of heel pain. Can be
unilateral or bilaterlal. The etiology is unkown, although it is thought to be
due to cumulative overload stress. It is worse when patient first stands up
when getting out of bed or after prolonged sitting. Get better with walking
but then worse after prolonged walking. Point tendernes to palpationon the
plantar surface of the heal. Condition lasts for months or years, and
resolves in most patinets over time. First line treatment is common off the
shelf insoles like Dr. sholes.
ACL tear - 🧠 ANSWER ✔✔Lachman's test is actually more sensitive then
anterior drawaer
MGUs - 🧠 ANSWER ✔✔becomes mulitple myeloma when thre is end organ
damage.
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, femorla neuroapthy - 🧠 ANSWER ✔✔can resutl form diabetes. symptoms
would be weakness of lower leg, giving way of the knee, and idscomfort in
the anteiror htigh.
oral contracptties - 🧠 ANSWER ✔✔decreases risk of ovarian cancer by
50%.
along with endometrial cancer and colorectal cancers.
frontotemporal dmetnia - 🧠 ANSWER ✔✔common cuase of demtnia in
those <65.. Often memory is preserved bu tinsight is gone.
Refeeding syndrome - 🧠 ANSWER ✔✔hallmark sign is hypophosphatemia.
Hoarness - 🧠 ANSWER ✔✔if it hasn't gone away in 3 months- time for a
laryngoscopy.
Urine drug tests - 🧠 ANSWER ✔✔morphine can show up in a perosn taking
cough medicine containing cough medicine
mono - 🧠 ANSWER ✔✔teenager with sorethroat, adenoapthy, and
myalgias, and fatigue.